Health care reform update

Using a health care FSA to pay for OTC medicines

or drugs? You will now need a prescription.
As of Jan. 1, 2011, you can no longer use your health care flexible
spending account (FSA) for over-the-counter (OTC) medicines or
drugs without a prescription. This change is part of the Affordable
Care Act passed in 2010.
Insulin, prescription medicines or drugs and some OTC supplies –
such as bandages, crutches, blood sugar test kits and contact solution
– will continue to be eligible, if your health care FSA plan allows.
Examples of OTC Examples of OTC supplies
If I get a prescription for an OTC medicine or drug, how do medicines or drugs that may continue to
I use my FSA to pay for it? that will require a be purchased with or
A
 t a grocery, department or other retail store (online, too) prescription for reimbursed from an FSA
FSA purchase or without a prescription:*
You can take the OTC medicine or drug off the shelf, pay out of reimbursement as of
ƒƒ Bandages
your pocket and submit a claim form to be reimbursed from your Jan. 1, 2011:
FSA. You will need to submit a copy of your receipt and your ƒƒ Braces and supports
ƒƒ Acid controllers
OTC medicine or drug prescription with your claim form. The ƒƒ Catheters
prescription must include: ƒƒ Acne medicine
ƒƒ Condoms
• Your name ƒƒ Aids for indigestion
ƒƒ Contact lens solution
• Name of medicine ƒƒ Allergy and sinus and supplies
medicine
• Dosage and form ƒƒ Crutches
- Quantity prescribed ƒƒ Anti-diarrheal medicine
ƒƒ Denture cleaners and
- Instructions ƒƒ Baby rash ointment adhesives
• Signature of the provider who wrote the prescription ƒƒ Cold and flu medicine ƒƒ Diagnostic tests and
A
 t a pharmacy (in person or online)
ƒƒ Eye drops monitors (such as blood
ƒƒ Feminine anti-fungal glucose monitors)
You can take your OTC medicine or drug prescription to a or anti-itch products ƒƒ Elastic bandages and
pharmacist to be filled and have a prescription number assigned. If ƒƒ Hemorrhoid treatment wraps
you have an FSA debit card, you may be able to use your card to pay
ƒƒ Laxatives or stool ƒƒ First-aid supplies
for it. Or, you can submit a claim form to be reimbursed from your
FSA. If you submit a claim form, you must include a receipt from softeners ƒƒ Insulin
the pharmacist that includes: ƒƒ Lice treatments ƒƒ Ostomy products
• Prescription number ƒƒ Motion sickness ƒƒ Pregnancy tests
• Your name medicines ƒƒ Reading glasses
• Date of purchase ƒƒ Nasal sprays or drops ƒƒ Walkers, wheelchairs
• Dollar amount ƒƒ Ointments for cuts, and canes
burns or rashes * Most major grocery,
department, retail and
For the latest health care reform ƒƒ Pain relievers, such as drug stores will be able to
information, visit [Link]. aspirin or ibuprofen identify at the cash register
ƒƒ Sleep aids what supplies may still be
purchased with an FSA
ƒƒ Stomach remedies debit card.
 How does this affect grace periods?
 OTC medicines or drugs bought prior to Jan. 1, 2011 but submitted for reimbursement
after Jan. 1, 2011 do not require a prescription to be considered for reimbursement under
the plan.
 The new restriction on OTC medicines or drugs began on Jan. 1, 2011 and will apply
regardless of any grace periods that extend to, on or after Jan. 1, 2011.

For example:
Your plan has a grace period through March 15, 2011, so you can be reimbursed from
your health care FSA for anything you bought up to that date. The grace period, however,
doesn’t apply to any OTC medicines or drugs you buy on or after Jan. 1, 2011, unless you
have a prescription — even though the claim is for reimbursement from your remaining
2010 FSA account balance.
There will still be limits on the amount of OTC items you can be reimbursed for from your
FSA. You will only be reimbursed for a reasonable quantity of an eligible OTC expense as
determined by the plan administrator.
Please remember to consider these new OTC rules when estimating the dollar amount to
put in your health care FSA for the next plan year.

For more information

ƒƒ Visit [Link], the federal government’s health care
reform website.
ƒƒ Visit [Link]. The Internal Revenue Service (IRS) publishes
information about FSAs and expenses.
ƒƒ Your employer may limit what items are eligible for health care FSA
purchase or reimbursement. Check your official benefit plan information
for details about your FSA.

UnitedHealthcare Insurance Company

This communication is not intended as legal or tax advice. Please contact a competent legal or tax professional for personal advice on eligibility, tax
treatment and restrictions. Federal and state laws and regulations are subject to change.
Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by
UnitedHealthcare Insurance Company, United HealthCare Services, Inc., or their affiliates.
100-10008 2/11 © 2011 United HealthCare Services, Inc.